Telehealth in patients with ALS: A systematic review Assessing the barriers and facilitators for implementation
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Care for patients with chronic diseases can be burdensome to the patient. Long days in the hospital with many different appointments are considered tiring and are often planned periodically. Telehealth is a method that enables patients to receive (part of) their care from home, either via remote consultations or via remote monitoring. A review about the telehealth care of patients suffering from ALS and the barriers and facilitators associated with implementation of this care was conducted in 2018. We wish to determine if the care as well as the barriers and facilitators associated with implementation has/have changed. In this systematic review we included all articles published between 2018 and October 2022 concerning these topics, and extracted the barriers and facilitators. These were placed in the CFIR framework for implementation. Use of telehealth is more widespread than in 2018, when patients receiving ventilation benefited most. All patients can now potentially benefit from telehealth. Telehealth is, like in 2018, given in two different ways. Via remote consultations and via remote monitoring. While some experimentations with remote monitoring are starting up, for example remote monitoring of diet, no big new ways of remote monitoring are implemented. Facilitators are mostly seen in the individual characteristics category and the relative advantage construct. Patients find that telehealth decreases disease- and care burden. Fewer barriers than before concern the healthcare professionals. The main barriers are seen in the outer setting, with problems concerning legislation and insurance reimbursement. In clinical trials a lot of new ways of monitoring the patient are being implemented. These innovative monitoring strategies will surely make their way to the care of the patient in the near future.